Freddie Collins attends Palliative Care Congress

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Hospice Ethiopia UK is delighted that our trustee, Freddie Collins, attended this year’s Palliative Care Congress in Belfast. This is the UK’s annual conference for palliative care practitioners and researchers. Here is her feedback:

“I was presenting an audit I completed while I lived in Ethiopia in 2024. For this audit, I went through the records of 100 patient notes to find out what symptoms they experienced and what medications the Hospice Ethiopia (HE) team used to manage their symptoms.

The main symptom that patients experienced was pain. 95% of cancer patients, and 91% of patients with HIV, experienced pain. On the first visit made by the HE team, only 5% of patients had their pain controlled. By their last visit, this proportion had increased to 60%. Most importantly, only 33% of patients had access to morphine, which is an essential medication to treat pain in patients at the end of their lives.

This audit shows two things. Firstly, how brilliant the HE nurses are! Even though they have a limited selection of tablet pain relief medications, they are still able to drastically improve pain in their patients. This is because, with your ongoing support, they are able to provide psychological, spiritual and economic support which helps to soothe pain in multi-dimensional ways.

Secondly, this audit highlights how an unmet need for pain control still does exist, as 40% of patients remain with uncontrolled pain at the end of their lives, but two thirds do not have access to oral morphine. If this study was repeated now on patients currently registered with Hospice Ethiopia, the access to oral morphine would probably be even more limited.

This inequitable access to morphine is a global problem. We can read in the 2018 Lancet Commission on Palliative Care and Pain Relief, how half of the global population receives less than 1% of global morphine supply. This audit therefore supports the urgent need for a reliable supply of oral morphine in Ethiopia and we hope that the Ethiopian government’s plan to develop a national morphine production unit will advance soon.”

Doctor receives palliative care training funded by HE UK

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Money raised by Hospice Ethiopia UK has been used to fund training for a doctor based in Southern Ethiopia, Dr Juhliad. His interest in palliative care started in 2019 when he received a three day introduction to palliative care at The Black Lion Hospital in Addis Ababa, delivered by Hospice Ethiopia’s Director, Ephrem. Dr Juhliad now works at Yabelo Hospital which is a town in the Oromia region, 580km south of Addis Ababa. Here he sees patients who desperately need symptom management and end-of-life care. With our help this year he has completed the foundation course in palliative medicine at Trivandrum Institute of Palliative Sciences and is now attending a Master Class course that will go on until December 2024. He will go to India for ‘hands-on’ clinical training in November 2024 as part of the course. This is what he told us:

“The hospital where I am based now doesn’t have a specific place dedicated to patients needing palliative care. And it seems difficult to persuade the hospital administrators to integrate palliative care services for now. But I am trying to integrate palliative care practice into my daily routine for patients who might be candidates for such services at a chronic disease medical outpatient department. Moreover, I am intending to launch a free telehealth service for patients needing palliative care through my social media platforms…I am also interested in providing webinars on palliative care for frontline healthcare workers.”

Staff news from Ethiopia

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We are delighted that Ephrem, Director of Hospice Ethiopia has been awarded his doctorate from the University of South Africa. He is the FIRST Ethiopian to have been awarded a doctorate in palliative care in the country. He studied ‘breaking bad news’ and identified the preferences of patients and individuals in how they would like to be informed of their condition when diagnosed with a life-threatening illness. He went on to develop a culturally sensitive guideline for breaking bad news in the palliative care setting in Ethiopia.

He commented “This represents a life time achievement through contributing to palliative care services in Ethiopia. The results will significantly contribute to Ethiopian patient care and treatment practice and decisions when life-threatening illness is diagnosed. Hopefully the results will be adapted for use in other African palliative care settings.”

Dr Barbro Norrstrom (a Swedish oncologist and palliative care specialist) summed up Ephrem’s achievement by saying “I’m so incredibly impressed by Ephrem, his great capacity, dedication, compassion for palliative care and the implications for all Ethiopians in need of palliative care, be it cancer be it other severe end of life illnesses, as well as the overall activities to get palliative care on the agenda, governmental, educational from top to bottom.”

Well done Ephrem!

In addition we wish to welcome Nurse Abenezer Tilahun, who has recently started work at Hospice Ethiopia. He was born in Addis Adaba and gained his Batchelors degree in Nursing at Debre Birhan University in 2017, followed by his Masters degree in Public Health at Yanet Health College in 2022. He has over 5 years clinical experience during which time he worked at the Armed Force Comprehensive and Specialised Hospital, the largest military hospital in Ethiopia. His induction at Hospice Ethiopia has been organised by Ephrem and he is currently working alongside Sr Filagot and Sr Kalkidan. He says “I am glad to be part of Hospice Ethiopia and the mission it stands for”.

Trustee visit to Hospice Ethiopia

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Sue and Jamie Mumford have just returned from a very productive trip to Ethiopia. This is what they had to say about their trip:

“We have just returned from nearly 3 weeks in Ethiopia. We have visited every year since we started supporting Hospice Ethiopia 11 years ago (except from in 2021 due to the coronavirus pandemic). We spent time with the staff of Hospice Ethiopia visiting their patients and reviewing how the money we transferred to them last year (£55,682) was spent as well as consulting on their budget plan for 2023. These discussions are really important for Hospice Ethiopia UK to understand the successes and challenges that the hospice faces.

We enjoyed a 2 day visit to Jimma University Medical Center (south western Ethiopia) where a new palliative care (care for people with life-limiting illnesses) department has been established following training given by Hospice Ethiopia 10 months ago. We were impressed by the team who are already providing comprehensive inpatient, outpatient, and home care. For those patients living outside Jimma they provide a telephone follow up service. We were privileged to have a meeting with Dr Fetiya (who is clinical director of this 800 bed hospital serving a catchment of 15 million population) where we discussed the ongoing problems with obtaining oral morphine for controlling pain. At present Tramadol is the strongest pain killer available, this means many of their patients do not have their pain adequately controlled (see photo below of Sue and Jamie with the team at Jimma).

The second week of our visit we travelled to Debark in north western Ethiopia to help deliver a 5 day palliative care course. This is the first time such training has been delivered in a very rural area. Many of the villages can only be accessed on foot or on a mule which presents additional challenges. Some of the 19 delegates had not heard of palliative care but by the end of the week they could see the huge need for this type of care when less than 1% of patients receive curative treatment for cancer. Hospice Ethiopia will provide mentorship to help with the implantation of palliative care in the hospital and health centres.

It was inspiring to see the impact that Hospice Ethiopia is now having on the expanding provision of palliative care in Ethiopia. With an estimated population of 120 million, there is still a long way to go but it is highly rewarding to know that Hospice Ethiopia UK is making a difference for those who suffer so much as they approach the end of their life. We are grateful to all our donors that enable us to continue to support Hospice Ethiopia. The trustees do not claim any expenses for their visits to Ethiopia, so every penny donated goes to where it’s desperately needed.”

‘Cuppas and Conversation’ event

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Fundraising got off to a good start for 2023 with a ‘Cuppas and Conversation’ morning in January in Trustees Sue and Jamie’s house in North Norfolk. This event was in aid of the Tewolde Medhane Fund (formerly the Comfort Fund), and a total of £276 was raised which will go towards those Hospice Ethiopia patients in the greatest of need. The Tewolde Medhane Fund exists to provide a small regular payment to such patients to pay for essentials such as food, rent, and clothing.

Welcome to Dr Fredrika Collins

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Hospice Ethiopia is delighted to be welcoming Dr Fredrika Collins to work as a volunteer for the next few months. Before she leaves the England’s shores, she is raising money for the Hospice by swimming between the 2 piers at Brighton – a distance of about 1km. Please support this valiant effort by donating via JustGiving.

Fredrika is an internal medicine trainee in Brighton, exploring a career in palliative care. In September 2022 she is moving to Addis Ababa, Ethiopia, to work for a year as a teaching fellow within the internal medicine department of Addis Ababa University. During this time she will also be volunteering for Hospice Ethiopia, by working clinically in their Day Care, Outpatients, and Home care programmes and assisting with education and training.

She completed her undergraduate medical degree at King’s College London, and foundation training at Croydon University Hospital. Between 2019-2020 she worked as a research assistant in Peru on a trial investigating the health benefits of clean cooking gas, before moving to Brighton to commence her internal medicine training.

She is particularly interested in the role of healthcare professionals in tackling local health inequalities, and set up the Health Education England approved ‘The Global Health Series’ in 2018, which continues to run at several trusts across London and the Southeast.

update on the big give christmas challenge 2020

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Ephrem teaching palliative care in Ethiopia

Many of our supporters generously donated to our Big Give Project last December. £9,500 was raised to design a standardised palliative care training course that could be delivered across Ethiopia to a range of Health Care Professionals.

We started our project early in January 2021 but nonetheless have not been able to complete the project yet due to the coronavirus pandemic and the ongoing difficult political situation in Ethiopia.

Ephrem Abathun (Director of Hospice Ethiopia) has worked with the Federal Ministry of Health (FMOH) and other stake holders to design the palliative care course and accompanying course material. This has been formally approved by the FMOH.

The training manual and accompanying material has now been printed. A zoom meeting is planned between Hospice Ethiopia, Hospice Ethiopia UK, and Palliative Care Works to take the project further.

 A pilot course is scheduled to be run in December 2021. Staff from the Simien Mountain Mobile Medical service will attend a 6 day course in Debark. It is hoped 2 trustees from Hospice Ethiopia UK will assist nurses from Hospice Ethiopia in delivering this training.

Following the pilot course, both the trainers and delegates will evaluate the course and adaptions will be  made accordingly, with help from the English charity, Palliative Care Works.

Many thanks again for your generous donations.

Ephrem visits the UK!

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We have had a very busy and enjoyable week with the Director of Hospice Ethiopia, Ephrem in the UK. First stop was the University of Surrey for a workshop about a research project looking at using mobile phone technology to extend palliative care and symptom control to remote rural areas of Ethiopia. The rest of his stay has been in Norfolk as guests of Hospice Ethiopia UK. While here he spent a fascinating day at Priscilla Bacon Lodge (Norwich) and The Market Surgery (Aylsham), seeing first-hand how palliative care is delivered in the UK.

On Saturday, Ephrem gave an informative presentation at St John of the Cross church, Aylsham to local supporters about his tireless work to relieve the suffering of the dying in Ethiopia. The audience was much moved and over £400 was raised to aid his work.

We’ve also endeavoured to give him a flavour of life in the UK. Fish & chips at Cromer was a must – the first time he had seen the sea – as well as visits to Norwich Cathedral, Aylsham & Holt market towns. His final visit was to Aldborough Primary School, who have been loyal supporters of Hospice Ethiopia. A question & answer session stimulated some very insightful questions from the pupils.

On leaving Norfolk Ephrem said “Of all the varied experiences this week, the most memorable was visiting a patient in their own home and seeing patients at Priscilla Bacon Lodge.”

Ephrem uk visit cropped

Aylsham Rotary club donation

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Aylsham Rotary club has raised an amazing £3000 to pay for Yohanna, a nurse at Hospice Ethiopia, to go to Hospice Africa Uganda in Kampala to study for her diploma in Palliative care.

Yohanna has said the following about this fantastic opportunity:

“My role as a palliative care nurse is to take greater responsibility for patient care and to become a specialist in areas such as pain management, symptom management and psychosocial support. In studying this diploma course in palliative care nursing, I hope that l will be able to make the most of these opportunities as my career develops. I anticipate that this diploma course in palliative care nursing will be the beginning of my lifelong career that will really make a difference in Hospice Ethiopia.”

Sue and Jamie attended a Rotary Club dinner in Aylsham at the Old Forge where Sue was able to update the members and guests about Hospice Ethiopia.

mum rotary talk